Challenges of Inappropriate Antibiotic Prescription in Dentistry and Threat of Antimicrobial Resistance in Developing Countries - Medicinal Plants to the Rescue

Abstract

Studies have revealed that Dentists across the globe are widely involved in the inappropriate prescription of broad spectrum antibiotics, a practice that is believed to contribute significantly to the current problem of antimicrobial resistance. The factors responsible for the inappropriate prescription of antibiotics by Dentists vary from country to country but the aim of such prescriptions appears to be universal-prevention of possible post-operative infections and complications. In developing countries, Dentists face some unique challenges that make such inappropriate prescription of antibiotics almost inevitable. Some of such challenges include an epileptic power supply and lack of potable water, both of which facilitate the poor infection control practices prevalent in these countries. The invasive nature of minor procedures such as simple tooth extractions and frequent use of poorly sterilized metal-based reusable equipment contribute to an increased risk of transmission of infections in dental practice. In the search for alternative antimicrobial drugs, medicinal plants have been observed to be potential sources of safer and cheaper agents, when compared to synthetic antibiotics. Interestingly, extracts from medicinal plants have long been applied for the treatment of oral infections and maintenance of oral health in many parts of the world, including developing countries, where they are widely distributed. Surprisingly, a very limited number of these extracts, if any, have found their way into the clinics as refined agents such as tablets, for the prophylactic control of post-operative infections in dentistry, especially in developing countries. This is largely due to lack of confidence on the part of Dentists and poor co-ordination among research institutions, pharmaceutical companies and regulatory bodies in these nations. This review therefore seeks to reawaken the interest of all parties concerned, on the need to harness the potentials of medicinal plants in solving the problem of inappropriate antibiotics prescription in dentistry.